I'd Rather Work Alone

UM Review RN, ASN, RN · Jun 12, 2006

Betty, you could do that. Or you could realize that you are their authority figure and write them up for failing to do their duties.

Obviously, the Care Tech position is as far as they're going in life, so they have no real motivation to do much of anything beyond the basics.

This is why a lot of facilities hire only techs who are planning on furthering their education. Even though the turnover is high, the reward is that the facility gets a highly motivated worker.

wonderbee, BSN, RN · Jun 13, 2006

You might prefer working in a critical care unit where you have only two pts but there are no "techs". Want to clean and turn? You need look no further than your neighbor nurse. We try to be there for each other. It makes for a tight knit group. Every once in a while we get a nurse intern... usually someone who had problems with their boards or licensing but already graduated... to help out. I love those days. They're unexpected bonuses.

Tweety, BSN, RN · Jun 13, 2006

Angie where I work only managers and charge nurses are allowed to write co-workers up. This is probably the best approach imo.

But I agree the nurse is the one in charge and needs to make clear what is expected. It's a shame to have to spend your time doing someone elses job.

It's a problem with a lot of new nurses, especially if they were techs prior, the aides don't seem to want to help them, when they are the ones who need the help the most.

Beary-nice · Jun 13, 2006

I found that I had to clearly express my expectations at the beginning of the shift and now I don't even have to do that anymore. When I am on and they see me, they know what I expect, no ifs ands or buts. I will gladly assist in cleaning pts up etc, but the CNAs know I expect the water pitchers to have water in them, the room to be clean, the lights to be answered etc. I have been in their shoes and they may or may not ever be in mine but we are there to take care of the pts together, and that is what I expect.

jb2u, ASN, RN · Jun 13, 2006

SkateBetty, first i am very sorry to hear about your situation. i know it must be hard trying to manage total patient care. that is why good cna's are SO valuable! i've posted many times on my feelings on this subject.

i am sure the cna's you are talking about are very lazy. as i said before, there are ALOT of lazy cna's out there! the problem is this.....first it is EXTREMELY easy to become a cna (it is a 70 question test that..the first 10 questions you miss don't count and out of the remaining 60 ?'s you only need a 40% to pass...that's 24 ?'s out of 70!!!, then a short skills test). secondly, the pay is sooooo low for cna work (NO this does not give one an excuse not to work), third and finally, there is ALOT of work to be done! as a cna/student nurse, i know for a fact that there is alot of work to do. there is no such thing as a cna to pt ratio!! we are there to assist the nurse not to do everything that does not require a license; however, alot of nurses feel it IS the cna's job to do everything (not requiring a license). this means cna's are extremely busy! why do i say this? well, none of the above reasons give a cna the right to be lazy; however, when you have a person that you practically give a certification to, put an unreasonable amount of work on, then pay them $6/hr......well, unfortunately...it attracts a certain type of person. i am not saying that it is right, but it is what it is. I would NEVER want to work as a cna as a career. i know of plenty of fellow student nurses that feel mistreated by nurses, overworked (nurses can always say, "oh i'm too busy to clean up pt so-an-so," but the cna can NEVER say that, even if it is true), and WELL underpaid. so, they do not work as cna's except for the minimum time required as a student nurse/cna. now, they are great cna's (you would love to have any of them i'm sure), but they are tired of being overworked, disrespected, and underpaid. they do not HAVE to work as cna's they just want the experience, so that just leaves the people that don't want to further their career (no motivation, maybe they feel that they can't get into school, maybe they didn't make it out of high school). just like nurses.... some are great..some are lazy! the great ones get overworked and the lazy ones stick together and talk about how the nurses don't do anything! so the good ones tend to leave!

but alas i have a solution...make the standards high to be a cna, increase the wages, and have a more appropriate cna to pt ratio. of course, hospitals will not go for this, but it is the solution. i even think, and i am sure some will be offended by this, but....i say do away with cna's and then....lpn's will do the cna's job (this REALLY helps the RN because the lpn can even help pass meds if the RN is behind), plus the lpn is better, ALOT BETTER at assessing a pt than a cna. plus the lpn will get alot more respect than the cna (yes, everyone no matter who they are wants to be treated with respect, and it does effect their job if they are disrespected). i believe the role of a cna is a VERY important role. and should be handled at a level higher than that of a cna. i am always going to my nurses when a pt looks like they are beginning to have skin breakdown, change in mentation, abnormal v/s, bm, urine output, etc. things that i know other cna's don't go to nurses about! (nurses have told me this, in two different hospitals and one nursing home!) any way...i hope no lpn's have taken offense to this...i know that you are all educated and capable nurses...I MEAN YOU NO DISRESPECT! if you take it as such then i think you are disrespecting the role of a cna...let's not forget that the role of a cna is a NURSES job...these are just task that a nurse CAN delegate!

once again i am sorry to hear about the lazy cna's that you work with. i hope to one day be the voice of change on this matter. and congratulations on becoming a nurse.

best of luck,

jay

LoriAlabamaRN · Jun 14, 2006

Write them up. If you do not have the authority to write them up, then keep a weeklong log wherein you document the work (or lack of work) the CNA is doing, including the response you get when youo ask for help. Then arrange a meeting with your DON, present your concerns and let her see in writing just how big the problem has become.

Drysolong · Jun 17, 2006

I know this one will probably stir someone up, but this is the place to say it. When I was a Nurse Tech (nice name for a student nurse/CNA) I worked my buns off keeping patients cleaned, turned, water and ice on the bedside tables, etc. Now that I'm a nurse I'm wondering where the payoff for that is? I can't squeak jack out of our Care Partners (another nice name for CNA), and I'm forever spending my time cleaning patients and chasing for water, and so on. It burns me up to go into a room with meds and the water pitcher is dry as bone. I have to either run for water or ask the patient to swallow their meds with tap water. In the meantime the CNA's have their heads down at the nurses station, catching a few zzz's, and snarling at me if I ask for help. I know it's a problem discussed many times over long before I became a nurse, but something occurred to me. I'd rather have one or two fewer patients, send the Care Partners home permanently for a nap, and do everything myself. It would get done faster and with less effort than what I spend coddling and stroking CNA's to get them to do their jobs.

I'm a brand new LPN still in orientation, so this is just my :twocents: . It has dawned on me that I am expected to be the supervisor of CNA's when there was no training in my LPN course on how to supervise CNA's. I come from a business background, where all supervisors and managers were given specific managerial training. I'm very sensitive to the subject of interactions between CNA's, Techs,etc., and Nurses (who are supv's and/or managers) In my clinical and now job settings, My observation is that many nurses have no clue on how to manage others with respect (regardless if the CNA is excellent or poor)

I think you are expecting the CNA's to be like you were (which is valid) but if they are NOT and they are not as highly motivated as you are/were, WHY NOT? I think that is a valid question that a supervisor should ask and be willing to provide solutions. For me, I am learning how to deal with snarls, dirty looks, etc., I'm here to do a job, not to make friends. BUT I strongly believe in respecting others and setting a professional tone.

jb2u, ASN, RN · Jun 17, 2006

it is my understanding that the ANA standardized the certification for cna's (a money making decision,i'm sure). so maybe if all nurses would write the ANA and ask for tougher standards to become a cna, well maybe you'd see more qualified cna's. cna's are a vital asset to getting your job done, as now you see, so let's get together to increase cna standards as well as wages.

i've noticied on this board how angered nurses get over how they were portrayed on House,er,gray's anatomy, etc....letters are written and calls are made....so why not get just as angry with the ANA and hospitals that are allowing certificates to be practicully given away and then giving a cna 15 pts to care for (to do all adl's,baths,bed changes, v/s, toileting, walking, d/c to car, get water, etc...is IMPOSSIBLE for one cna, especially with the attitude of SOME nurses that don't do some of the above pt care).

again, ask for cna's to have higher standards, better wages, and better cna to pt ratio's and i GUARANTEE you will love the results.

a call to change,

jay